Under Anatomy department of PNNM Ayurveda Medical College

1. KAKSHADHARA
MARMA
PRESENTATION BY,
Dr AFEEFA CHULLIKULAVAN
HOUSE SURGEON
Dept. Of RACHANA SHAAREERA
PNNM AYURVEDA MEDICAL COLLEGE
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2. Contents
• Marma
• Kakshadhara marma
• Varmology
• Modern perspective of kakshadhara marma
• Articles
• Stimulation of kakshadhara marma
• Clinical study
• Acupuncture areas v/s kakshadhara marma
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3. “ Natural forces within us is the true healer of a disease”
(Hippocrates)
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4. • Ma means prana or vayu.
• Repha means seat
• Hence Marma means Seat of vayu or prana.
Definition
विषमं स्पन्दनं यत्र पीविते रुक
् च ममम तत् |(AH)
where pulsation or pain occurs.
Marma
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5. ममममवि नमम ममंसवसरमस्नमय्िस्थिसस्िसविपमतम:,
तेषु स्वभमित एि विशेषेि प्रमिमस्िष्ठस्ि, तस्ममन्मममस्ववभहतमिमम्स्िमन् भमिमनमपन्त्यिे |
(Su Sa 6/3)
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6. Kakshadhara Marma
• One among बमहुममम
• Also िैकल्यकर ममम –हते िैकल्यजनने |
• A/c to Susruthacharya- स्नमयुममम.
A/c to Vagbhatacharya- वसरमममम.
• प्रममि – 1 अङ् गुल (width/size)
• 2 in number- one on either side
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7. Location
• िक्ष: कक्षयोममध्ये कक्षधरं (SuSa 6)
It is situated between chest and armpit
• कक्षमक्षमध्ये कक्षधरं (AH Sa)
• Represented by Vitapa Marma.
Anatomical Location
2 finger beneath lateral 1/3rd of clavicle.
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8. Kakshadhara marma vidha lakshana
स्नायुममम विद्ध लक्षण
कोब्ज्यं शरीरमियिसमद: वियमस्वशस्ििुमूलम रुजश्च |
वचरमद्व्रिो रोहवत यस्य चमवप तं स्नमयुविद्धं मनुजं व्यिस्येत् ||
(Su. Su 25/36)
विरा ममम विद्ध लक्षण
वसरममममव्यधे समन्द्रमजस्रं बह्वसृक
् स्रिेत् |
तत्क्षयमत् तृट् भ्रमश्वमसमोहवहध्ममवभरिक ||
(AH. Sa. 4/50)
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9. • This can even cause पक्षमघमतं
तत्र लोवहत क्षयेि पक्षमघमतः।(Su. Sa. 6)
• क
ु वित्वं तत्र जमयते | (A.H.Sha.6/9)
• तेषममन्यतम पीिमयमं समवधकम पीिम
भिवत, चेतनमवनबि िैशेष्यमत् |
(Cha.Si.9)
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10. Treatment
• विस्िष्टदेहं पवततं मवितं हतमेि च |
िमसयेत्तैलपुिममयमं द्रोण्मं ममंसरसमशनम् ||
अयमेि विवध कमयम क्षीिे मममहते तिम |
(Su.Chi.2/75)
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11. • अवभष्यण्णम महमदोष मममथिम व्यमधयश्च ये |
उरुिम्भ पभृतयो रुक्षिीय वनदवशमतम || -
(Cha.Su.)
• Massage (brhmana?)
For controlling ममंसिह स्रोतस् use वतलतैलं,महमममषतैलं
Use kuzhambu
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12. Varmology
• Subtle energy that function in body called varma & has 108 varmas
• An ancient Indian medical system
• Depends on
 5 elements (lym bhootham)
 3 humours (vali,azhal,iyam)
 10 vital airs (vali 10)
 10 energy pathways (naadis)
 vital energy (vaasi)
 kundalini
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13. Yenthi kaalam
• Kakshadhara marma may be compared with this varma
• Located where arm pit meets the chest(ant axillary folds)
• Finger placement-clench with pulp of middle 3 fingers
while thumb placed on shoulder for support
• ¼ maathirai pressure,clench and release 3 times
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14. 14
Location Finger placement Application

15. • Injury to this varma cause
1.delirium
2.pain in the upper limbs
3.increases body temperature
4.loss of hearing
• It should be corrected immediately
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16. • Treatment in varma therapy
1.stimulation of varma point
2.herbal & metal treatment
3.extracts of living organism as medicine
4.astronomical treatment
5.tantric treatment
• Provides energy to upper limbs
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17. Modern perspective of kakshadhara marma
• Nerves
1.brachial plexus (posterior, lateral & medial cords)
2.median nerve
• Blood vessels
1.Axillary artery
2.Axillary vein
• Muscles
1.pectoralis major
2.pectoralis minor
3.intercoastal muscles
• Lymph drainage to axillary glands
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18. Complete lesion
• Only after severe injury & is often fatal
• Anesthesia of whole upper limb except that supplied by C3,C4 & C5
• Complete paralysis of scapular muscles
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19. Incomplete lesion
• Due to stabs, cuts, traction or pressure
• Upper brachial plexus lesion(Erb-duchenne)
Due to excessive depression of shoulder, displacement of head
Muscles involved are biceps, brachialis, brachioradialis, supinator
& deltoid
Limb will be policeman taking a tip posture limb internally rotated,
extended at elbow & pronated
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20. Lower brachial plexus lesion(Klumpke)
• Due to
Falling person clutching an object & hyperabducting his arm
Failing to obtain a foot hold on a passing bus
• Resulting in
paralysis of intrinsic muscles of hand(claw hand)
anaesthesia of inner 1&half fingers
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21. Median nerve injury
• The patient is unable to bend the terminal phalanx of the thumb and index finger
• The forearm is kept in a supine position due to paralysis of the pronators.
• Flexion at the interphalangeal joints of the index and middle fingers is lost called
pointing index finger
• Ape or monkey-like thumb deformity & sensory loss in hand
• Skin on lateral 3½ digits is warm, dry and scaly. The nails get cracked easily
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22. Axillary artery & vein injury
• Uncommon-may result in permanent limb disability
Pectoralis major & minor injury
• Tendinopathies(collagen breakdown in tendon)
• Due to extensive tension on a maximally contracted muscle or direct trauma
• Symptoms
 Tearing sensation
 Painful limitation of motion
 Localised swelling, asymmetry & echymosis
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23. 1.Study of importance of kakshadhara marma w.s.r to Erb’s palsy
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24. 2.Kakshadhara marma w.s.r to kalaripayattu
Phanam marma same location and traumatic effects
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25. Stimulation of kakshadhara marma
Stimulation of kakshadhara Marma :-
• Clearance of the blocked channels in the body
• Beneficial for patients of frozen shoulder
• For relieving muscular tension in the shoulder joint.
• Muscle wasting or pain in the upper shoulder region or scapular region.
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26. Procedure
• Patient should sit straight and relaxed
• Head should not be tilted or bend downwards
• Ask the patient to relax by deep breathing.
• Sitting posture is better than supine
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27. • Stand in front of the patient
• Keep his thumb on the marma point while 4 fingers on coracoid process
• With the help of the pulp of the thumb, he applies the pressure slightly upwards and
backwards.
Note: Pressure should not be applied downwards as it may lead to the injury of the
brachial plexus
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28. Determining pressure to be applied
The pressure application on kakshadhara marma is moderate(6-8 pounds
pressure approx).
• Amount of pressure applied also depends on:
>age of the patient
>sensitivity or सत्वं of the patient(प्रिर, अिर, मध्यम )
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29. Clinical evaluation of marma therapy in frozen shoulder
• Study carried out in 30 patients
• Done by giving digital pressure twice a day on Kshipra, kurpara, Kakshadhara and
Amsa marma
• Each marma stimulated for 20 times in one sitting in the rhythm of our respiration
• The effects were noted in 4 stages
>immediately after MT > 1 day after MT
> 1 week after MT > 15 days after MT
>follow up was done after one month.
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30. • On statistical analysis highly significant changes were observed in:
1.reduction in pain
2.increase in ROM
3. Reduction in joint stiffness
4.patient reporting any untoward incident or complication
was insignificant
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31. Acupuncture areas and marma
• Body treated as whole-Several systems of
function- Zang fu(yin yang forces)
• Health means balance between yin and yang
• Disease-yin/yang forces unbalanced/
blocked/stagnant
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32. • Interventions-pressure, heat, acupuncture
applied to body’s acupuncture points
• Zang fu- yin channel(3 in each limb)
& yang channel(3 in each limb)
• Qi (vital energy) move as a circuit
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33. 3 yin channels of hand
 Lung, pericardium & heart
 begin on chest
 travel along inner surface of arm to hand
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34. 34

35. • 3 yang channels
 Large intestine, san Jiao &
small intestine
Begin on hand
 Travel along outer surface of arm
to head
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36. Discussion
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• Validity of marma stimulation in clinical practice
• Integration of Varmology in marma
• Integration of kalaripayattu in marma
• Brachial plexus injury versus marma injury

37. Conclusion
• It is the area where main nerves & vessels reside
• Injury leads to vaikalya or ruja
• Knowledge of varmology & acupuncture can be applied alongwith our treatment
in कक्षधरममम विद्ध
• Marma therapy is a non-invasive alternative method which is fast acting
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38. Reference
1. Susrutha SS. Vaidya Jadavji Trikamji Acharya with Nibandha Sangraha Commentary of Sri Dalhanacharya. Published by Chaukhamba
Sanskrit Sansthan, Varanasi, Reprint Edition. 2013:399.
2. Das S. A concise textbook of surgery. Dr. S. Das.; 2006.
3. Hridayam A, KR SM. Krishnadass Academy. Varanasi;1998.
4. Dr. Premanand Bhalerao, Study of Applied Aspects of Kakshadhara Marma W.S.R. To Phanam Marma of Kalary Payyatu. International
Ayurvedic medical Journal 2016
5. ShanmugomN, Basic concepts of medical varmalogy hand book on varmam therapy- kaibhagam and seibhagam, Thirumoolarvermology
institute;2017
6. Mangrule PU, Nikumbh MB, Dawre MK, Rathod ST. STUDY OF IMPORTANCE OF KAKSHADHARA MARMA WS R TO ERBS PALSY. International
Journal of Ayurveda and Pharma Research;2017 Mar 5.
7. Chaurasia BD. Human anatomy. CBS Publisher; 2004.
8. Samhita C. Charaka samhita. Vols I-‐VI, Jamnagar, India: Shree Gulab Kunverba Ayurvedic Society. 1949.
9. Vivek J. Comprehensive study on marma & acupuncture points and evaluation of their therapeutic importance (Doctoral dissertation,
RGUHS).
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39. Thank you
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